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Monoamniotic twins with one fetal anencephaly and cord entanglement diagnosed with three dimensional ultrasound at 14 weeks of gestation.

Jo YS, Son HJ, Jang DG, Kim N, Lee G - Int J Med Sci (2011)

Bottom Line: A 29-year-old pregnant woman with parity 0-0-0-0 was diagnosed with monoamniotic twin pregnancy discordant for anencephaly at 14 weeks gestation.Umbilical cord entanglement, which is an important cause of fetal death in monoamniotic twins, was confirmed by three-dimensional ultrasound.Cesarean section was performed at 34 weeks of gestation, and the normal newborn infant was discharged without any complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, St. Vincent's Hospital, Catholic University of Korea, Seoul, Korea.

ABSTRACT
A 29-year-old pregnant woman with parity 0-0-0-0 was diagnosed with monoamniotic twin pregnancy discordant for anencephaly at 14 weeks gestation. Umbilical cord entanglement, which is an important cause of fetal death in monoamniotic twins, was confirmed by three-dimensional ultrasound. Cesarean section was performed at 34 weeks of gestation, and the normal newborn infant was discharged without any complications. We report a case of monoamniotic twin pregnancy discordant for anencephaly and diagnosed with cord entanglement by three-dimensional ultrasound at 14 weeks of gestation, and now report it along with a literature review.

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Related in: MedlinePlus

A three-dimensional ultrasound image demonstrates that the normal fetus put his arms around the shoulders of the other fetus with anencephaly and leaned against him at 22 weeks of gestation.
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Figure 2: A three-dimensional ultrasound image demonstrates that the normal fetus put his arms around the shoulders of the other fetus with anencephaly and leaned against him at 22 weeks of gestation.

Mentions: A 29-year-old pregnant woman with parity 0-0-0-0 visited the hospital at 14 weeks after spontaneous pregnancy. Abdominal 2D ultrasound (Voluson E8, GE Healthcare, USA) revealed that the first twin was within the normal ranges for the gestational age but the second twin showed anencephaly. There was one placenta and no amniotic membrane separated the two fetuses, and both were male. Umbilical cord entanglement was observed by using 3D ultrasound (Voluson E8, GE Healthcare, USA) (Fig. 1). The parents received counseling regarding monoamniotic twin pregnancy, anencephaly of a fetus and complications of umbilical cord entanglement. The patient underwent weekly prenatal medical examinations at the outpatient clinic. A fetal ultrasound conducted at 22 weeks did not show any abnormal finding except for one fetal anencephaly (Fig. 2). Starting from 26 weeks, a Doppler study of the umbilical cord and a non-stress test were performed every week and their results were within normal ranges. Also, amniotic fluid index (AFI) was checked every week, polyhydramnios (AFI = 25) was detected at 26 weeks and persisted until delivery (AFI: 20 ~ 28). The polyhydramnios was asymptomatic and was not treated. Although hospitalization for intensive observation was recommended at 30 weeks of pregnancy, the patient refused such treatment. While she was examined as an outpatient, preterm labor occurred at 33+5 weeks and she was subsequently hospitalized.


Monoamniotic twins with one fetal anencephaly and cord entanglement diagnosed with three dimensional ultrasound at 14 weeks of gestation.

Jo YS, Son HJ, Jang DG, Kim N, Lee G - Int J Med Sci (2011)

A three-dimensional ultrasound image demonstrates that the normal fetus put his arms around the shoulders of the other fetus with anencephaly and leaned against him at 22 weeks of gestation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198252&req=5

Figure 2: A three-dimensional ultrasound image demonstrates that the normal fetus put his arms around the shoulders of the other fetus with anencephaly and leaned against him at 22 weeks of gestation.
Mentions: A 29-year-old pregnant woman with parity 0-0-0-0 visited the hospital at 14 weeks after spontaneous pregnancy. Abdominal 2D ultrasound (Voluson E8, GE Healthcare, USA) revealed that the first twin was within the normal ranges for the gestational age but the second twin showed anencephaly. There was one placenta and no amniotic membrane separated the two fetuses, and both were male. Umbilical cord entanglement was observed by using 3D ultrasound (Voluson E8, GE Healthcare, USA) (Fig. 1). The parents received counseling regarding monoamniotic twin pregnancy, anencephaly of a fetus and complications of umbilical cord entanglement. The patient underwent weekly prenatal medical examinations at the outpatient clinic. A fetal ultrasound conducted at 22 weeks did not show any abnormal finding except for one fetal anencephaly (Fig. 2). Starting from 26 weeks, a Doppler study of the umbilical cord and a non-stress test were performed every week and their results were within normal ranges. Also, amniotic fluid index (AFI) was checked every week, polyhydramnios (AFI = 25) was detected at 26 weeks and persisted until delivery (AFI: 20 ~ 28). The polyhydramnios was asymptomatic and was not treated. Although hospitalization for intensive observation was recommended at 30 weeks of pregnancy, the patient refused such treatment. While she was examined as an outpatient, preterm labor occurred at 33+5 weeks and she was subsequently hospitalized.

Bottom Line: A 29-year-old pregnant woman with parity 0-0-0-0 was diagnosed with monoamniotic twin pregnancy discordant for anencephaly at 14 weeks gestation.Umbilical cord entanglement, which is an important cause of fetal death in monoamniotic twins, was confirmed by three-dimensional ultrasound.Cesarean section was performed at 34 weeks of gestation, and the normal newborn infant was discharged without any complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, St. Vincent's Hospital, Catholic University of Korea, Seoul, Korea.

ABSTRACT
A 29-year-old pregnant woman with parity 0-0-0-0 was diagnosed with monoamniotic twin pregnancy discordant for anencephaly at 14 weeks gestation. Umbilical cord entanglement, which is an important cause of fetal death in monoamniotic twins, was confirmed by three-dimensional ultrasound. Cesarean section was performed at 34 weeks of gestation, and the normal newborn infant was discharged without any complications. We report a case of monoamniotic twin pregnancy discordant for anencephaly and diagnosed with cord entanglement by three-dimensional ultrasound at 14 weeks of gestation, and now report it along with a literature review.

Show MeSH
Related in: MedlinePlus